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OVERVIEW

What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (also called BPH) is the medical term for an enlarged prostate.  The condition affects the prostate gland in men. The enlargement isn’t caused by cancer or infection.

The prostate makes semen. It is found between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may press on the urethra.   This can cause a slower, weaker urine stream.

SYMPTOMS

What are the symptoms of BPH?

Most symptoms of BPH start gradually. They include:

• Getting up more often at night to urinate.
• Having to empty the bladder often during the day.
• Difficulty in starting the urine flow
• Dribbling after urination ends.
• Decrease in the size and strength of the urine stream.
• Incontinence, or difficulty controlling urination.

These symptoms can be caused by other things besides BPH. They may be signs of more serious diseases, such as a bladder infection or bladder cancer. Contact your healthcare provider if you have any of these symptoms, so they can decide which tests to use to find the possible cause.

Severe BPH without treatment can lead to bladder and kidney infections.

CAUSES

The exact cause of BPH isn’t well understood. It appears to be related to aging. About 50% of men over age 50 have BPH. Up to 90% of men older than 80 have it. The following factors could increase your risk of BPH:

• Age 40 or older.
• Family history of BPH.
• Being obese.
• Heart and circulatory disease.
• Type 2 diabetes.
• Lack of exercise.
• Erectile dysfunction.

Changing hormone levels as a man ages may also be to blame.

DIAGNOSIS & TESTS

How is BPH diagnosed?

Your healthcare provider will ask you about your symptoms. They will do a rectal exam to check your prostate. For this, your healthcare provider will put a gloved, lubricated finger into your rectum. They will feel the size of your prostate gland.

Your healthcare provider may do blood or urine tests to make sure that your prostate problem is benign. An ultrasound exam or a biopsy of the prostate may also help in the diagnosis.

PREVENTION

Can BPH be prevented or avoided?

There is nothing you can do to prevent or avoid BPH. Exercise, controlling your type 2 diabetes, and losing weight may reduce your risk of BPH.

TREATMENT

Treatment for BPH depends on what symptoms you have and how severe they are. Options include lifestyle changes, medicine, minimally invasive procedures, and surgery.

Lifestyle changes

If your symptoms are mild or only slightly bothersome, you can usually control them with simple changes. These include:

• Reducing liquid intake, especially before bed or going out in public.
• Avoid caffeine, alcohol, and over-the-counter medicines that make you urinate more.
• Train your bladder to hold urine longer.
• Exercise your pelvic floor muscles.
• Preventing constipation.

Medicine

Your healthcare provider may prescribe different medicines to treat BPH. Some of these improve urine flow or reduce blockages in the bladder. Others stop or shrink the growth of the prostate. Sometimes a combination of different medicines is used. Your healthcare provider will recommend medicine based on your symptoms and condition.

Minimally invasive procedures

One option is a minimally invasive treatment. This means it does not involve surgery. Most of these treatments use heat to destroy prostate tissue that is pressing on the urethra. Minimally invasive treatments can sometimes be done by your healthcare provider in their office. This is done by inserting a catheter (a thin, flexible tube) through the urethra to reach the prostate. These treatments may require local, regional, or general anesthesia.

These treatments relieve symptoms. They do not cure BPH. Your healthcare provider will consider your symptoms and overall health when deciding what procedure you should have.

Surgery

Surgery is the most effective treatment. It is a last resort when other treatments fail. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done through the urethra, leaving no scars. Surgery does have risks, such as bleeding, infection or impotence. These risks are generally small.

Living with BPH

BPH is not life-threatening, but it can be bothersome. There are also some complications that can occur. These include:

• Inability to urinate.
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• Blood in the urine.
• Urinary tract infections.
• Bladder or kidney damage.
• Bladder stones.

Some men have urinary symptoms that are not related to BPH. They could be the signs of a more serious condition, including prostate cancer. Contact your healthcare provider if you notice any of the following symptoms:

• Complete inability to urinate.
• Painful, urgent, and frequent need to urinate.
• Blood in your urine.
• Pain in the lower abdomen and/or urinary tract.
• Fever or chills along with any of the above symptoms.